| NPI | 1639121262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0068418) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101246545) |
| 207R00000X Internal Medicine (Licence: DC MD038790) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-06-01 |